Paediatric Diabetes – Leaving Home

Hundreds of young people each year leave their family home, either because they are just ready to make a home of their own or because they are off to University or College.

If you have type 1 diabetes there are some extra factors to consider.

Meal patterns away from home can be very different. You may even be cooking and shopping for yourself for the first time. In this situation it is easy to forget to eat or miss a meal altogether so:

• Be prepared
• Get organised
• If all else fails, at least make sure you have bread and cereals available for a snack or meal and fast acting glucose for hypo treatment.

Make sure you consider registering with a General Practitioner locally – some Universities/Colleges have a campus doctor who will need to be aware of your diabetes. Consider where you wish to continue your Diabetes care if at University – will it be at home or are you going to transfer all your care to your chosen place for University – talk it over with you Diabetes Team.

Consider safe insulin storage – you will be able to apply for a refrigerator in your room if you are at university/college. Your Diabetes Team can do a letter to support your application for this and also for student disability allowance whilst you are studying. Your Diabetes Nurse will be able to help you with a letter to the University to support your application.

You will meet new friends and they need to know about your diabetes to be able to support you if you have a problem such as being ill.

Your social life may be hectic! You will do the same as your friends but do remember that alcohol and recreational drugs can have a profound effect on blood glucose levels.

When going out remember:

• Make sure you eat prior to drinking alcohol.
• Try to limit alcohol, drink low calorie soft drinks.
• Have a good supper after drinking alcohol and have a back-up plan if you have had too much alcohol
• Know how to manage your insulin pump when drinking alcohol
• Be sure to carry diabetes identification at all times.
• Make sure a friend with you knows you have diabetes and knows what to do if you have a hypo.
• Carry your usual hypo treatment

Do you know what to do if you are ill?
Common coughs, colds or “flu” viruses will affect your diabetes control. This may be the first time you have needed to deal with illness alone. During any episode of illness, you can expect your blood sugars levels to mostly rise although a sickness and diarrhoea bug could make you blood glucose levels go down. There are a few points to remember:

• Never stop taking your insulin or stop your insulin: doses may need to increase even though you may not be eating.
• Make early contact with your Diabetes Nurse
• If unable to eat, try replacing usual meals with alternatives i.e. soup, ice cream, fruit juice, lucozade, non-diet coke or pop, glucose, honey or jam.
• Drink plenty of non sugary fluids hourly.
• Test your blood sugar levels 2 hourly.
• If your blood sugar is more than 14mmol/l test for blood ketones.
• Give extra corrections of insulin as per your sick day rules. Keep a copy of your full sick day rules for insulin injection or pump therapy where you can find it quickly.
• Never go to bed on a rising blood glucose level, stay awake, monitor and bring down levels. Tell a friend so that you have some support and they can check in on you.
• Keep a copy of the full sick day rules for insulin injection or pump therapy where you can find it quickly.
• If you have ketones and are vomiting this is an emergency situation and you must go straight to the nearest Accident and Emergency department – you may have DKA (diabetic keto-acidosis), do not forget that this can be a life threatening situation.

Check out the leaflets on sick day rules/hyperglycaemia management and those about the effects of alcohol and other recreational drugs so that you are well informed and able to keep yourself safe in this exciting new phase of your life.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.